Adam Kay used to be a doctor. After working 97-hour weeks, enduring sleepless nights while managing life and death situations, he couldn’t take it any longer. Adam quit medicine and turned to writing.
His book, This Is Going to Hurt: Secret Diaries of a Junior Doctor, puts the spotlight on the kinds of pressures he and others faced daily. In one passage he writes, “I went six months without laughing, every smile was just an impression of one. I felt bereaved. I should have had counseling. In fact my hospital should have arranged it. But there’s a mutual code of silence that keeps help from those who need it most. I didn’t tell anyone the reason why I left.”
It’s strange how such stories seem to come in clusters. I watched a news item this morning in which a hospital consultant described how well-trained his staff was in dealing with major trauma on a large scale. But the thing they hadn’t accounted for was how it would make them feel afterwards. The one thing they hadn’t even considered was the effect on their own mental health, and they paid a price as a result.
What stops us speaking out?
There are a number of reasons people don’t like talking about depression. At the most basic level there is nothing appealing, attractive, or particularly interesting in declaring depression. When we ask, “How are you?” how many of us seriously expect an answer along the lines of, “Well, I’m pretty sure I’m depressed”? Many of us simply aren’t equipped to know how to respond.
For the sufferer, at perhaps the most sensitive and vulnerable point in their life, the notion of being judged as incapable or unworthy is a good enough reason to keep their lips firmly sealed. Even if colleagues offer sympathy and support, such things tend to come with a time limit. Few people are willing or able to help carry a busy workload on top of their own.
Another reason people may not talk about depression is that they simply don’t want to. Men are a classic example. Depression may be viewed as a weakness and so many men become irritable, angry and self-contained. They commonly blame their mood on work yet much of their increased workload may be self-imposed as a distraction. Solace is sought at the bottom of a bottle or other distractions considered “manly.”
It’s easy to dismiss the “male code,” which equates depression with femininity and weakness, as ill-informed and unhelpful — but it’s a potent force. What is perhaps more alarming is the fact that such codes exist in places of work where, frankly, people should know better. Thomas L. Schwenk, MD, of the University of Nevada School of Medicine, Reno, wrote an editorial in the Journal of the American Medical Association (JAMA) in which he states, “Physicians are less proud and less willing to admit or discuss that, as a profession, they are at equal risk for depression and higher risk for suicide than that of the general population…. [T]he best efforts fall short, mostly because of the high levels of stigma attached to seeking mental health care.”
We might like to think that our own health professionals would be standard setters for mental health and that we could model ourselves on their lead. Unfortunately the opposite seems to be the case. Stigma is such a powerful force. In 2016 The Guardian newspaper ran an article suggesting eight out of 10 doctors in England have experienced mental health issues. A quick review of the personal stories is quite revealing. Most, for example, had not sought help. Of those who disclosed their problems to a superior, responses included, “You cannot tell people you feel that way. They’ll judge you. Just keep your head down.” Another experienced bullying from a consultant. Another stated, “I have met doctors before who don’t believe in mental illness.”
The great sadness with all of these stories is that so much suffering is needless. It takes a few seconds to undertake an internet search on the benefits of talking about depression. Depression is isolating and energy sapping but it begins to lose its power and influence if its effects are brought out into the open. We can’t ignore the fact that a great deal of ignorance still exists, even in the medical professions.
Fortunately, a balance can be struck between facing up to depression and not fearing its effects on others or ourselves. There are increasing numbers of well-informed and well-trained therapists who know exactly how best to help. Different types of therapy suit different needs, but in cases of mild depression, just sharing with a loved one can lift a great deal of the burden. If talking is an unrealistic proposition in your work environment, then talk to someone outside it. The cause of your depression may be a different issue. It may be that one day you need to come to your own conclusions over whether what is happening to you is really worth the pain.
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Jerry Kennard, Ph.D., is a chartered psychologist and associate fellow of the British Psychological Society. Jerry’s clinical background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of positivityguides.net.